Evaluation of Montreal cognitive assessment for the differential diagnosis of mild cognitive impairment and Alzheimer’s disease in elderly patients with more than 5 years of schooling: Data from a Brazilian sample

摘要

Background: Diagnostic investigation of dementia is based on a series of tests which lie the neuropsychological evaluations. The Montreal Cognitive Assessment (MoCA) was developed as an instrument to recognize Mild Cognitive Impairment (MCI) and initial cases of Alzheimer’s disease. The present study aims to evaluate the predictive value of Brazilian MoCA test version in a sample of elderly above 5 years of education. Methods: Cross-sectional study with 136 elderly, above 60 years old at least 5 years of education. Diagnostic criteria is based on clinical and neuropsychological data classified Alzheimer’s disease n = 52, MCI n = 45 e normal controls n = 39. MoCA test was compared with Cambridge Cognitive Examination, Mini-Mental State Exam, Verbal Fluency, Clock Drawing Test, Geriatric Depression Scale and Pfeffer Functional Activities Questionnaire. Accuracy was evaluated by receiver operating characteristic (ROC) curve analyses. Pearson correlation coefficient was used to compare the MoCA with the other tests. It was also used logistic regression analysis to identify the main risk factors for the diagnostic groups. Results: MoCA was the best test to differentiate Alzheimer’s disease cases from MCI with 86.5% sensitivity and 75.6% specificity. Furthermore, analyzes of correlation test showed that MoCA correlates robust way of already validated with other tests and wide application inBrazil. Conclusions: It can be concluded that MoCA is a good screening tool for investigation of MCI among the elderly in Brazil with over 5 years of schooling. Studies with larger numbers of participants are needed to further validate the test also for elderly people with low education.